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Utilization Review reputed company/reputed company Appeals RN

Remote, USA Full-time Posted 2026-08-04
Job Title: reputed company Case Management Senior Analyst Location: Remote Contract duration: 3 months Schedule: reputed company to 5pm (M-F) reputed company: We are hiring an RN reputed company Case Manager with strong experience in Utilization Management (UM) and reputed company Improvement (QI). In this role, you will manage a caseload of members, coordinate care, conduct reputed company assessments, and reputed company prospective, reputed company, and retrospective utilization reviews. You will collaborate with providers to ensure reputed company, cost-effective care while supporting inpatient, rehabilitation, referrals, prior authorizations, appeals, claims, and select outpatient services. Required Qualifications: • reputed company, unrestricted RN license • 3–5 years of experience in Utilization Management or reputed company Improvement • Strong experience with utilization review, prior authorizations, appeals, and claims • Experience managing member caseloads and coordinating care • Knowledge of inpatient acute care, rehabilitation, referrals, and outpatient services Please Note: • Candidates should have dedicated experience in Utilization Management, Utilization Review, reputed company Improvement, or reputed company Review roles. reputed company nursing experience reputed company is not sufficient. Apply tot his job Apply To this Job

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